What should you know about FAP colectomy age?

There is no single colectomy age for FAP; timing depends on polyp burden, symptoms, cancer risk and specialist assessment. Familial adenomatous polyposis causes many colorectal polyps because of an inherited change, so care usually involves planned surveillance. The decision about [Bowel Resection](/treatments/surgical-oncology/colectomy/) balances the condition of the bowel with the effects of surgery and the person’s development, health and preferences.

A specialist may recommend surgery when polyps cannot be safely controlled with surveillance and removal, when symptoms develop, when suspicious changes appear, or when cancer is found. The operation may remove part or all of the colon, with reconstruction or a stoma considered according to the anatomy and surgical plan. The rectum may need its own surveillance if it remains.

Age alone does not decide the timing. Polyp number, size, appearance, bleeding, anaemia, bowel function, family circumstances and access to follow-up can all affect the discussion. The plan can change as examinations provide new information.

Ask for care from a team familiar with inherited bowel conditions. Keep scheduled examinations and ask what findings would move the plan towards surgery. [Colonoscopy](/treatments/cancer-screening/colonoscopy/) can help inspect and remove suitable polyps, but it does not remove the inherited tendency. Discuss surgical options, bowel function, fertility or pregnancy plans, school or work, nutrition and emotional support. Close relatives may need genetic counselling and an appropriate screening plan.

Contact your care team promptly for rectal bleeding, persistent change in bowel habit, worsening abdominal pain, unexplained tiredness or symptoms of anaemia. Seek urgent help for heavy bleeding, severe or distending abdominal pain, repeated vomiting, fainting or inability to pass stool or gas. Do not wait for a routine surveillance appointment when these symptoms are severe or rapidly worsening.

How many polyps do I have, and are any concerning? What findings would make surgery advisable now? Which operation is being considered, and how might it affect bowel function? Will the rectum need continued surveillance? What should my relatives know about assessment?